New York Penal - Article 210 - § 210.45 Making a Punishable False Written Statement

Penal
§ 210.45 Making a punishable false written statement.
A person is guilty of making a punishable false written statement when
he knowingly makes a false statement, which he does not believe to be
true, in a written instrument bearing a legally authorized form notice
to the effect that false statements made therein are punishable.
Making a punishable false written statement is a class A misdemeanor.